HEENT, Throat, Regional Lymphatics Flashcards
1
Q
_____ & _____ (__________) are ideal places to check facial features for symmetry
A
- nasolabial folds
- palpebral fissures (opening btw eyelids)
2
Q
cranial nerve 5
A
- trigeminal
- responsible for sensation in face & motor fxns like biting and chewing
- largest of cranial nerves
3
Q
cranial nerve 7
A
- facial nerve
- facial expression
4
Q
sutures
A
closed cavity on the skull
5
Q
parotid glands are located where?
A
just below and in front of each ear
6
Q
2 other pairs of major salivary glands
A
- sublingual (under tongue)
- submandibular (under jaw)
7
Q
what does your parotid gland connect to?
A
- Stensen’s duct (tube)
- carries saliva to mouth, release it near upper molar teeth
- sialolithiasis-calcified stones (calculi)
8
Q
trigeminal neuralgia
A
intermittent sharp shooting facial pain lasting several mins over divisions of the 5th trigeminal cranial
9
Q
what ages make a headache is worrisome?
A
- child < 5
- adults > 50
10
Q
what type of headache is indicative of meningitis?
A
headache that moves into the neck, causing neck pain w/ head flexion
11
Q
a typical migraine headache has?
A
- prodromal symptoms
- visual disturbances, vertigo, tinnitus, and/or numbness or tingling of fingers + toes
12
Q
what is indicative of a migraine headache?
A
throbbing severe pain on one side of head, along w/ ringing in ears prior to headache
13
Q
what headache is an early sign of increased intracranial pressure (ex: brain tumor)?
A
morning headaches that subside after rising
14
Q
cluster headaches
A
- typically localized in eye + orbit
- radiate to facial + temporal regions
15
Q
what characteristics to ask about headaches?
A
- dizziness?
- light-headedness?
- spinning?
16
Q
what to ask for history in HEENT associated w/ headaches
A
- head injury (when, severity, state of consciousness)
- history of head/neck surgery
- lumps/swelling in neck
17
Q
history of HEENT
A
- vision changes
- diplopia
- hearing (earache, tinnitus, hearing loss)
- vertigo
- epistaxis
- sore throat; hoarseness
- swollen glands
- goiter
18
Q
for the physical exam, inspection is followed by?
A
palpation
19
Q
inspection then palpation of head
A
- normocephalic
- symmetry
- lumps
- bumps
- pain
20
Q
inspection than palpation of temporal artery
A
- pulse
- temporal artery is a major artery located btw the eye and top of the ear
21
Q
temporal arteritis
A
- temporal artery is hard, thick, tender w/ inflammation
- may lead to blindness
22
Q
the strength of pulsation of the temporal artery may be ____ in older adults
A
decreased
23
Q
inspection then palpation of face
A
- symmetry
- tenderness
24
Q
temporomandibular joint (TMJ)
A
- place index finger over front of each ear & ask pt to open mouth
- palpate for swelling, tenderness, crepitation, pain, ROM
25
inspection then palpation of sinuses
- frontal
- maxillary
26
inspection then palpation of parotids
- tender
- enlarged
27
_____ can cause swelling of the parotid gland
viral infections (EX: mumps, flu)
28
what occurs w/ parotid gland enlargement?
asymmetry of face anterior to earlobes
29
what is associated w/ damage/trauma to facial nerve (7) or herpes simplex virus infection?
Bell's palsy
30
Bell's palsy
- begins suddenly + reaches peak w/in 48 hrs
- twitching, weakness, paralysis, drooping eyelid/corner of mouth, drooling, dry eye/mouth, decreased ability to taste, eye tearing, facial distortion
- one-sided facial paralysis main
31
Parkinson's disease
- mask-like facial appearance
- shuffling gait
- rigid muscles
- diminished reflexes
32
Neck has?
- major muscles
- blood vessels
- trachea
- thyroid glands
- lymph nodes
33
abnormal findings of neck
- nuchal rigidity
- HA
- elevated temp
- ^associated w/ meningitis or encephalitis
34
where to find lymph nodes in head/neck?
- preauricular
- postauricular
- tonsillar
- occipital
- submandibular
- submental
- superficial cervical
- posterior cervical
- deep cervical
- supraclavicular
35
history for regional lymphatics
- pain
- lumps
- discharge
- rash
- swelling
- trauma
- history of breast dz
- surgery
- self-care behaviors
36
what lymph nodes are usually not palpable?
axillary lymph nodes
37
axillary lymph nodes enlarge when?
- local infection of breast , arm, hand
- breast cancer metastases
38
abnormal lymph nodes w/ acute infection
- enlarges
- warm
- tender
- firm
- moveable
39
abnormal lymph nodes w/ HIV
- enlarged
- firm
- non-tender
- mobile
- occipital nodes often involved
40
abnormal lymph nodes w/ chronic infection
clumped nodes
41
abnormal lymph nodes w/ cancer
- hard > 3 cm
- unilateral
- non-tender
- fixed
- matted
42
abnormal lymph nodes w/ Hodgkins
- rubbery
- discrete
- appear gradually
43
abnormal lymph nodes w/ Virchow's (sentinel node)
- hard
- non-tender
- left supraclavicular node
- highly suggestive of thoracic/abdominal cancer
44
in about 1/3 of population, _____ extends upward from the _____ or ________.
- third lobe
- Isthmus
- one of the two lobes
45
how to palpate trachea and what are you inspecting + palpating for?
- place finger in the sternal notch then feel each side of the notch + palpate tracheal rings
- inspect and palpate for tracheal shift
46
abnormal inspection and palpation of thyroid
enlarges and/or tender to palpation
47
what is heard w/ auscultation of the thyroid w/ hyperthyroidism? why?
- soft, blowing, swishing sound
- increased blood flow thru thyroid arteries
48
if the thyroid can be palpated, the right lobe is often ____ than the left lobe normally
25% larger
49
sign of thyroiditis
enlarged, tender thyroid gland
50
what suggests a malignancy w/ the thyroid?
rapid enlargement of a single nodule
51
what indicates hyperthyroidism?
diffuse enlargement of the thyroid gland
52
what is not considered an abnormality in older adults?
increased in nodularity in the thyroid
53
after inspection + palpation, auscultating the thyroid, the pt should?
hold your breath to obscure any tracheal breath sounds during auscultation
54
during the trachea/thyroid exam, the neck should be?
slightly extended w/p being turned to any side
55
the pt does what during inspection/palpation of the thyroid gland, but not during auscultation?
swallows water
56
ask the patient to ________. observe the movement of the _____ cartilage and gland.
- swallow a small sip of water
- thyroid
57
the ____ and ____ cartilage move upward symmetrically as the client swallows.
- thyroid
- cricoid
58
thyroid gland symmetrical w/ _____. gland ______ with swallowing. ____ lobe may be up to ____ larger than the ___ lobe and tissue ____ and _____.
- small lobes
- rises freely
- right
- 25%
- left
- firm
- pliable
59
what is considered abnormal for the thyroid gland?
- asymmetric movement
- generalized enlargement
60
_____ of a single thyroid nodule suggests ______ and must be evaluated further.
- enlargement
- malignancy
61
what suggests an enlarged thyroid gland, inflammation of lymph nodes, or a tumor?
swelling, enlarged masses or nodules
62
how to detect thyroid enlargement, nodules, masses, or tenderness?
palpating thyroid gland
63
when examining the thyroid gland, the nurse?
- insepects for enlargement and asymmetry
- auscultates for bruits
- palpates for tumors, masses, size, tenderness
64
what does not provide meaningful data for the thyroid gland?
percussion
65
the nurse should auscultate the thyroid only if?
an enlarged thyroid gland is identified during inspection or palpation
66
hypothyroidism
a condition in which the body lacks sufficient thyroid hormone
67
hypothyroidism manifestations
- edema around the eyes
- dry, coarse, sparse hair
- puffy, dull face
- cold intolerance
- muscle cramps
- constipation
68
hyperthyroidism
- overactive thyroid
- thyroid gland produces too much of the hormone thyroxine
69
hyperthyroidism can ____ your body's metabolism significantly, causing sudden weight _____, a ______ heartbeat (______), ______, and _____ or ________.
- accelerate
- loss
- rapid or irregular (tachycardia)
- sweating
- nervousness
- irritability
70
hyperthyroidism: lab data indicate that the pt's ______ hormone levels are elevated. too much of the hormone ____ is secreted.
- T4 and T3
- thyroxine
71
the nurse auscultates an enlarged thyroid gland to search for?
presence of a bruit
72
use of tobacco and heavy alcohol consumption increases?
risk of cancer
73
gingivitis
red, swollen gums that bleed easily (early gum dz)
74
periodontitis
destruction of the gums w/ tooth loss (more advanced)
75
dental pain may occur with?
- dental caries
- abscesses
- sensitive teeth
76
what is seen w/ aphthous stomatitis and herpes simplex? what are the other names for these 2 dzs?
- canker sores (aphthous stomatitis)
- cold sores (herpes simplex)
- painful, recurrent ulcers in the mouth
77
what are warning signs of cancer?
- mouth/tongue sores that do not heal
- red/white patches that persist
- lump/thickening
- rough, crusty, or eroded areas
78
nose mouth throat history
- hoarseness
- medications (OTC nasal meds)
- chronic alc + tobacco
- dry mouth
- check oral hygiene practices
- cheilosis of lips
79
misuse of OTC nasal meds can?
irritate mucosa and cause rebound (common)
80
cheilosis of lips
scaling, painful fissures at the corner of lips
81
asking about proper use of nasal decongestants may explain?
recurrent sinus congestion + infection
82
nasal mucosa is normally?
- dark pink
- moist
- free of exudate
83
the nasal septum is normally?
- intact
- free of ulcers, deviations, or perforations
84
turbinates are usually?
- dark pink (redder than oral mucosa)
- moist
- lesions-free
85
the nose should normally have an absence of?
sniff
86
inspection: nose
check patency, mucosa nasal deviations
87
palpate: nose
discomfort
88
instructions for nose bleed
sit up, lean, forward, and pinch your nose
89
with a nose bleed, advise the person to ___, lean ____, and digitally compress the lower soft part of the nose for ______.
- sit
- forward
- 15-20 minutes
90
inability to breath through both nostrils may indicate?
- sinus congestion
- obstruction
- deviates septum
91
rhinorrhea and what it indicates
- thin, watery, clear nasal drainage
- chronic allergy
- pt w/ past head injury: cerebrospinal fluid leak
92
yellow mucous drainage indicates?
- cold
- rhinitis
- sinus infection
93
local causes of epistaxis
- trauma
- mucosal irritation
- septal abnomrality
- inflammatory dzs
- tumors
94
systemic causes of epistaxis
- blood dyscrasias
- arteriosclerosis
- hereditary hemorrhagic telangiectasia
- idiopathic
95
common causes of epistaxis
- local trauma (most)
- facial trauma
- foreign bodies
- nasal/sinus infections
- prolonged inhalation of dry air
96
four pairs of sinuses
- frontal
- maxillary
- ethmoid
- sphenoid
97
examine the sinuses through?
palpation and percussion
98
frontal or maxillary sinuses are tender to palpation in?
- allergies
- acute bacterial rhinosinusitis
99
large amount of exudate ____ upon palpation of _____.
- crepitus
- maxillary sinuses
100
what is seen in acute sinusitis (infection of the sinuses)?
- pain
- tenderness
- swelling
- pressure around the eyes
101
chronic sinusitis
- sinus become inflamed and swollen
- symptoms last 12 wks or longer even w/ treatment
102
palpate the maxillary sinuses by?
pressing w/ thumbs up on the maxillary sinuses
103
frontal + maxillary sinuses are tender upon percussion in pts w/?
- allergies
- sinus infection
104
percussion of the sinuses is not performed in an effort to?
gauge particular sounds
105
lips are normally?
- smooth
- moist
- w/o lesions or swelling
106
jaws are normally?
- aligned
- no deviation seen w/ biting down
107
gums are normally?
- pink
- moist
- firm
- tight margins to the tooth
- no lesions or masses
108
tongue should normally be?
- pink
- moist
- moderate size
- w/ papillae (little protuberances)
- no lesions
- no red color
109
what to use when holding pt's tongue to each side?
square gauze pad
110
what should be even among cheeks and gums?
color + consistency of tissues
111
the dorsal surface of the tongue is normally?
- roughened from papillae
- thin, white coating may be present
- ventral surface may show veins normally
112
indication of atrophic glossitis
smooth, glossy areas on tongue
113
inspect both sides of the tongue for?
cancer lesions
114
palpate what on the tongue for?
- lesions
- dryness
- ulcers
- nodules
- for induration
115
what is seen on the tongue during dehydration?
deep tongue fissures
116
a normal variation of the tongue in older adults is?
fissured, topographic-map-like tongue
117
if white plaque on the tongue is removable, it is more likely a?
candida infection
118
yeast infection of the tongue and what it requres
- thick, white plaques on soft palate and tongue
- require tx w/ meds
119
is white plaque on the tongue cannot be removed, it is?
leukoplakia
120
what on the tongue indicates cancer and should be referred?
- leukoplakia
- persistent lesions, ulcers, or nodules
121
what increases the likelihood of cancer?
induration
122
smokers may have what on their tongue?
- yellow-brown coating
- not leukoplakia
123
throat: ask the client to say "aaah" and watch for the ____ and _____ to move bilaterally and symmetrically. what is this testing?
- uvula
- soft palate
- testing CN IX & X
124
what should be midline and rises with "ah" in the throat?
uvula
125
what can cause deviation of the uvula?
- damage to CN X
- diphtheria
- poliomyelitis
126
when applying a tongue depressor, depress the tongue slightly _____ to avoid ____.
- off-center
- eliciting the gag response
127
normal tonsils are?
- involuted
- granular in appearance
- appear to have deep crypts (indentions)
- pink mucosa
128
what can develop in tonsil crypts? normal or abnormal?
- plugs of white debris in tonsil crypts
- normal
129
bright red and swollen tonsils indicate?
infection
130
white membrane (exudate) covering tonsils can accompany?
- infectious mono
- leukemia
- diphtheria
131
1+ tonsils size
visible
132
2+ tonsils size
half way btw tonsillar pillars + uvula
133
3+ tonsils size
touching the uvula
134
4+ tonsils size
touching one another
135
eyes - subjective data
- vision-floaters
- halos or scotoma
- partial/complete loss of vision
- photophobia, night blindness
- pain, foreign body
- strabismus (squint), diplopia
- redness, swelling
- discharge
- hx. eye probs
- glaucoma
- wear glasses/contacts/corrective surgery
- eye exam - when? (freq)
136
vision-floaters is seen in?
- myopia
- over age 40
137
halos or scotoma is seen in?
blind spot slightly w/ diminished peripheral vision
138
glaucoma
halos around light
139
eye - objective data
- eye exam (shape, color, size)
- inspect conjunctiva + sclera
- visual acuity
- pupillary light reflex
- visual fields (confrontation)
- extra-ocular movement
140
the sclera and palpebral conjunctive should be?
- sclera - white
- palpebral conjunctiva - pink
141
unless the conjunctiva is diseased, only visualizing sclera + palpebral vascular bed through the?
translucent conjunctiva
142
how to better visualize sclera + palpebral conjunctivae
gently pull lower eyelid downward + ask the patient to look upward
143
the sclera can appear ____ in pts w/ liver dz.
yellow
144
in pts w/ conjunctivitis, the conjunctiva can become?
pinkish-red
145
the iris should be?
round w/ an even distribution of color
146
when shining penlight into eye, the lens should be ____ what indicates cataracts?
- transparent
- cloudly lens
147
visual acuity tests?
cranial nerve II
148
how to test visual acuity
- Snellen chart
- 20 ft away from chart - one eye at a time
- covers one eye w/ an opaque card
- reads each line of letters until he/she can no longer distinguish them (lowest line possible)
149
normal acuity
20/20
150
Near vision uses what cards?
Rosenbaum cards
151
how far away should the Rosenbaum card be to test near vision?
about 14 in away
152
what line do pts read to w/ the Rosenbaum card?
lowest possible line
153
how does the pt read the Rosenbaum cards (the set up)?
reads letters w/ glasses if needed
154
normal near vision means?
- 14/14
- person can read what the normal eye can read from a distance of 14 in
155
record the pt's visual acuity as a fraction. the numerator indicates _________ and the denominator indicates ___________.
- distance pt is from the chart
- distance at which a normal eye can read the line on the chart
156
20/25 visual acuity means
client can read at 20 ft what the avg pt can read at 25 ft
157
visual acuity: the large the denominator, the _____ the vision.
worse
158
legally blind
vision that cannot be corrected to better than 20/200
159
normal pupillary response
constriction of the pupils and convergence of the eyes when focusing on a near object (accommodation and convergence)
160
pupillary size (bright light and dark light)
- 3-5 mm in bright light
- 4-8 mm in dark light
161
pupillary response to light is what cranial nerve?
CN III
162
how to test pupillary response
- advance the light from pt's side
- shine light from lateral side of eye or from beneath to help ensure client dosn't accommodate pupils for near vision
163
direct pupillary response
constriction of the pupil w/ light
164
consensual pupillary response
simultaneous constriction of other pupil
165
when testing for the consensual response, what should the nurse do?
place a hand or another barrier to light btw person's eyes (avoid inaccurate finding)
166
when light is shone in one eye, the eye will ______ and the opposite (_______) eye will also ______.
- constrict
- consensual
- constrict
167
direct reflex of eye
shining light in one eye w/ resulting constriction of that rye
168
optic chiasm
point where the optic nerves from each eyeball cross
169
when does accommodation occur?
client moves the focus of vision from distant point to a near object - cause pupils to constrict
170
convergence
pupils constrict; both move to center to focus on object
171
accommodation (distant + near)
- distance: dilates
- near: constricts
172
PERRLA
pupils equal, round reactive to light & accommodation
173
visual fields (confrontation) tests?
assess peripheral vision w/ examiner's vision
174
visual fields (confrontation) direction
- equal height; 2 ft away
- cover one eye; examiner covers opposite eye
- look directly at each other w/ uncovered eyes
- fully extend left arm at midline + slowly move 1 finger (or pencil) upward from below until pt sees finger/pencil (inferior)
- test remaining 3 visual fields of pt's right eye (superior, temporal, nasal)
- repeat test for opposite eye
175
eyes EOM
- extraocular motion (EOM)
- assess ability of eyes to move through 6 cardinal positions of gaze (CN III, IV, VI)
- note conjugate movement, nystagmus
176
normal EOM
- steady head
- eyes follow finger movement thru 6 positions in clockwise direction
177
CN III, IV, VI
- III: oculomotor
- IV: trochlear
- VI: abducens
178
failure of eyes to follow movement symmetrically in any/all directions for EOM indicates?
- weakness in one or more extraocular muscles or dysfxn of CN that innervates particular muscle
179
Nystagmus
oscillating (shaking) movement of eye
180
nystagmus may be associated w/ ?
- inner ear dz
- multiple sclerosis
- brain lesions
- narcotics use
181
when is nystagmus considered normal?
a couple of oscillating movements of nystagmus at extreme lateral gaze
182
corneal light reflex test is also called?
Hirschberg test
183
corneal light reflex tests and assess?
- test balance of extraocular muscles
- assesses parallel alignment of eyes
184
corneal light reflex test: asymmetric position of the light reflex equals?
deviated alignment of eyes
185
strabismus/tropia
- constant misalignment of the eye axis
- strabismus defined according to direction toward which the eye drifts
186
esotropia
eyes turns inward
187
exotropia
eye turns outward
188
cover-uncover test can be used to screen for?
strabismus, EOM
189
cover-uncover test: pt is instructed to?
cover one eye; nurse observes uncovered eye movement as it focuses on an object
190
right esotropia
- right eye usually in with left eye uncovered
- left eye covered, right eye moves outward to pick up fixation
191
an abnormal finding during the cover-uncover test is strabismus, where?
one eye deviates to the middle due to weakened extraocular muscles
192
tropia
direction of the strabismus (or misalignment)
193
hypertropia
eye deviated upward
194
hypotropia
eye deviated downward
195
how to conduct cornea light reflex test/Hirschberg test
(1) use light source like penlight
(2) instruct pt to focus gaze on light source
(3) at 2 ft distance: shine light source equally into pt's eyes at the midline
(4) observe reflection of light off cornea: should appear as pin-point white light near center of same pupil spot in each eye
196
if there is normal alignment during the cornea light reflex/Hirschberg test, then?
reflection will appear in the same position in each pupil
197
if there is a misalignment of the eyes during the cornea light reflex/Hirschberg test, then?
location of the corneal reflex will appear asymmetric + "off center" of pupil in deviating eye
198
misalignment, Hirshberg's: the relative difference in the position of the reflex will be?
in the opposite direction as the eye deviation
199
Hirschberg test is useful for strabismus testing in?
- newborns
- young children
- pts w/ poor vision
- pts that cannot fixate/track well
- any situation where full motility eval not feasible
200
esotropia in Hirschberg test
light reflex will appear outwardly displaced from center of pupil
201
hypertropia in Hirshberg test
light reflex will appear inferiorly displaced from the center of pupil
202
objective findings in exophthalmos
- apparent eye protrusion
- lids don't reach iris
- measurement of degree of exophthalmos performed using exophthalmometer
203
objective findings in strabismus
- eye will not move in direction controlled by affected muscle
- abnormal cover-uncover result
204
objective findings in cataracts
- cloudly lens
- may be obvious w/o equipment
205
objective findings in glaucoma
- optic nerve damage (clearly seen during dilated eye exam)
- characteristic of cupping of optic nerve
- visual field test show peripheral vision loss
206
an eye that fells firm/resistant to palpation could indicate?
glaucoma or tumor
207
anisocoria
difference in size of pupils (brain injury)
208
ptosis
dropping upper lid
209
miosis
constricted (pinpoint) pupils (narcotic drugs or brain damage)
210
mydriasis
dilated pupils (CNS injury, circulatory collapse, deep anesthesia)
211
monicular blindness can be detected when light directed to blind eye results in?
no response in either pupil bc optic neuropathy/ocular disorder produce acute visual loss
212
light is directed to the unaffected eye in a pt w/ monicular blindness results in?
both pupils constricting
213
arcus senilus
grey-white arc/circle caused by lipid deposition around limbus of older adult
214
what is the effect of arcus senilus on vision?
no effect
215
arcus senilus is possibly r/t?
cholesterol
216
xanthelasma
- benign lesions usually on eyelids
- soft, raised yellow plaques occurring on lids at inner canthus
- frequently seen in females
217
corneal abrasion
- one of the most common eye injuries
- pain, erythema, tearing, photophobia
218
conjunctivitis
- clear/purulent discharge
- usually viral but can be bacterial
- commonly tx w/ antibx
219
subjective data of the ear
- earaches
- drainage
- loss of hearing
- tinnitus
- vertigo
- env noise exposure
- bloody or clear watery drainage
220
earaches can come from?
- ear infections
- cerumen blockage
- sinus infections
- teeth/gum probs
221
drainage of the ear can also be called and can come from?
- otorrhea
- infection
222
potential causes of tinnitus
- excessive earwax buildup
- high BP
- certain ototoxic meds
- loud noises
223
examples of ototoxic medications that can cause tinnitus
- streptomycin
- gentamicin
- kanamycin
- neomycin
- ethacrynic acid
- durosemide
- indomethacin
- aspirin
224
vertigo causes?
- dizziness
- spinning
225
vertigo stems from?
inner ear/labyrinthitis/vestibular nerve prob (vestibular neuritis)
226
bloody or clear watery drainage is likely to be _________ and can indicate?
- cerebrospinal fluid
- basal skull fracture after a srs accident or head injury
227
tympanic membrane
- pearly gray, shiny, translucent
- no bulging or retraction
- slightly concave, smooth, intact
228
normal findings of the tympanic membrane using the otoscope
- cone-shaped reflection
- 5 o'clock in right ear
- 7 o'clock in left ear
229
dense, white patches and scars on the tympanic membrane are?
sequelae of repeated ear infections in childhood or earlier
230
bluish or dark red color to the tympanic membrane would suggest?
skull trauma
231
what can prevent the nurse from viewing the tympanic membrane?
impacted cerumen
232
what can suggest acute otitis media?
- red, bulging eardrum
- distorted, diminished, or absent light reflex
233
the ear is lined with glands that secrete?
cerumen
234
type of cerumen found in Caucasians and African Americans
wet, honey brown
235
type of cerumen found in East Asians and American Indians
dry, flakey white
236
cerumen's purpose
lubricate, waterproof, and clean the external auditory canal
237
cerumen is not needed to? too much cerumen can?
- transmit sound through the auditory canal
- impair hearing
238
cerumen is also _____ and traps ________. wet, honey-colored cerumen is ________.
- antibacterial
- foreign bodies
- not a sign of infection
239
gross examination of the external ear and middle requires an _______. how should you position an adult's ear for the examination?
- otoscope
- pull auricle of ear up and back
240
whisper test
- gross assessment for high-frequency sounds
- whisper two-syllable words like popcorn or football
241
whisper test is associated with what CN?
CN 8
242
Presbycusis
high-frequency hearing loss that occurs with aging
243
conductive hearing deficit
cerumen impaction + otitis media most common cause
244
flaking wax in the external ear is/is not pathologic?
is not
245
what happens when the ear's labyrinth becomes inflamed?
feeds the wrong info to brain, causing:
- staggering gait
- vertigo
246
vertigo
strong, spinning, whirling sensation
247
in general, vertigo is from?
- labyrinth of the ear
- vestibular nerve issue
248
perform the _____ test if diminished or lost hearing in one ear
Weber
249
the Weber test detect _____ conductive hearing loss (______ hearing loss) and _______ sensorineural hearing loss (_____ hearing loss)
- unilateral
- middle ear
- unilateral
- inner ear
250
weber test: conductive loss will cause the sound to be heard best in?
- abnormal ear
- pt hears the sound in poor ear (bone vibration)
251
weber test: sensorineural loss will cause the sound to be heard best in?
- normal ear
- where you can listen to sound best in air conduction only
252
weber test: in sensorineural loss, the _______ of sound due to nerve damage in bad ear makes the sound seem louder in?
- limited perception
- the unaffected ear
253
Rinne test is used to determine?
the cause of the hearing loss
254
Rinne test: first, tuning fork on the _______. after the prongs are moved to the front of ____.
- mastoid process
- external auditory canal
255
Normal Rinne test
AC (air conduction) twice as long as BC (bone conduction)
256
sensorineural hearing loss Rinne test
AC > BC
257
conductive hearing loss Rinne test
BC ≥ AC
258
why is BC ≥ AC in Rinne test with conductive hearing loss?
air conduction thru the external/middle ear is impaired so vibrations thru bone bypass the impairment to reach the cochlea
259
why is AC > BC in Rinne test with sensorineural hearing loss?
- both are decreased
- inner ear/cochlear nerve less able to transmit impulses regardless of how vibrations reach the cochlea
260
weber test: sensorineural hearing loss may be caused by what?
- presbycusis
- gradual nerve degeneration that occurs w/ aging + by ototoxic drugs (affect hair cells in cochlea)
261
purulent otorrhea
- ear drainage
- probable otitis externa or perforated tympanic membrane
262
_______ drainage suggests an infection of the external ear (_____) w/ _______ of pinna & ear canal and _______ regional lymph nodes
- purulent, bloody
- external otitis
- redness, swelling
- itching, fever, enlarged tender
263
_______ associated with ____ and a _____ sensation is characteristic of otitis media with perforation of the tympanic membrane associated with ________.
- purulent drainage
- pain
- popping
- bloody, clear, or resembles pus
264
in otitis externa, the patient experiences pain when?
the pinna and the tragus are moved
265
otitis externa
enlarged superficial cervical nodes
266
otitis externa is also associated w/ ______ and is nicknamed?
- submersion in water
- swimmer's ear
267
older adult's thyroid may feel more _____ bc of _____ changes that occur w/ aging.
- nodular/irregular
- fibrotic
268
the thyroid of an older adult may also be felt ____ in the neck because of age-related ______.
- lower
- structural changes
269
age-related changes: ____ visual acuity, visual fields; light/dark adaptation
lowered
270
age-related changes: ___ sensitivity to glare
increased
271
age-related changes: presbyopia
loss of near-focusing ability
272
age-related changes:__ incidence of glaucoma
increased
273
age-related changes: ___ depth perception
distorted
274
age-related changes: less able to differentiate?
blues, greens, violets
275
age-related changes: __ eye dryness + irritation
increased
276
increasing age, esp over 75, risk factors for?
cataracts
277
_____ are normal over 40 years of age.
vision-floaters
278
age-related changes: __ hearing acuity, esp to hear _____
- decreased
- consonants
279
age-related changes: loss of hearing from ______ and ___
- high frequency
- presbycusis
280
otosclerosis
- progressive conductive hearing loss in young adults btw 20-40 yo
- gradual bone formation causes stapes footplate to become fixed in oval window, impeding transmission of sound + causing progressive deafness
281
age-related changes: difficulty hearing, esp w/ ?
- background noise
- rapid speech
282
age-related changes: __ cerumen, cerumen _____ so ____ cerumen impaction
- increased
- drier
- increased
283
age-related changes: __ olfactory nerve fibers = ___ ability to smell noxious odors
- decreased
284
age-related changes: ____ food intake
- decreased
285
age-related changes: altered ability to taste? what remains unchanged?
- altered sweet and salty
- bitter and sour unchanged
286
age-related changes: tongue looks ____ because of?
- smoother
- papillary atrophy
287
age-related changes: teeth are slightly ____ and appear ____ because of?
- yellowed
- longer
- recession of gingival margins
